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1617 Clemson Dr B410111' CityofEaaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 SEP 10CD1 Use BLUE or BLACK Ink Permit#: c - c- "�01 / Pi Permit Fee: Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: t - ,-1 b Site Address: 1In \ - N'1(----1 Tenant: avtA �L.ArY wY1 Suite #: RESIDENT / OWNER Name: V\0\_1(1) i\V WT \ V`Y�1M Phone:J °- - Ll J Address / City / Zip: \ l o \ —1 - 3 C....\ v 'Zr �CZ Applicant is: Owner Contractor TYPE OF WORK Description of work: :S(UCGC QMI ;Dtt ' '. . Construction Cosh lU,C 11 Multi -Family Building: (Yes / No ) CONTRACTOR Named .C. Or ---L -'S zit-sc.-AS License #: Address: `t0' r v, K.V'u. a ,c 1\ve , City:Cr--.�--\ State: NAN Zip: '5 \"i J Phone: LtS \ - Z `/ ' Q 75 7:9-- Contact: Z_ Email: COMPLETE In the last 12 months, has Yes If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a penult for a similar plan based on a master plan? date and address of master plan: _No Licensed Plumber: Phone: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: NOTE: Plans and supporting documents that you submit ane considered to be pubtic tufa lrmatlon. Po� Of the information may be classified as non-public if you pmvlde specific reasons would p the City t+ conclude that they ars trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicants Printed Name AlSplicantSignature Page 1 of 2 ,-\ /‘/-7 647)_<07A b4 - DO NOT WRITE BELOW THIS LINE q61-7( SUB TYPES Foundation Single Family Multi 01 of _ Plex T Accessory Building WORK TYPES New Addition Alteration cC, Replace // Retaining Wall DESCRIPTION Valuation Plan Review Fireplace Garage Deck Lower Level _ Interior Improvement _ Move Building Fire Repair Repair (25%_ 100% ) Census Code (` # of Units # of Buildings Type of Construction vis REQUIRED INSPECTIONS Footings (New Building) _ Footings (Deck) _ Footings (Addition) Foundation Drain Tile _ Roof: _Ice & Water Final '`C Framing _ Fireplace: Rough In Air Test Insulation Meter Size: Reviewed By: Porch (3 -Season) _ Porch (4 -Season) _ Porch (Screen/Gazebo/Pergola) T Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Siding Reroof Windows _ Egress Window Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous _ Demolish Building* Demolish Interior Demolish Foundation ;.> Water Damage *Demolition of entire building — give PCA handout to applicant N )4) 7 MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required y Final / No C.O. Required HVAC Other: Pool: Footings Air/Gas Tests _Final Siding: _Stucco Lath Stone Lath Brick _Final Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 2 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT City of En Permit Type: Permit Number: Date Issued: Permit Category: Mechanical EA084441 07/17/2008 ePermit Site Address: 1617 Clemson Dr B Lot: 2 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-020-02 Use: Description: Sub Type: e - Fumace & Air Conditioner Work Type: New Description: Fumace & Air Conditioner Comments: Questions regarding electrical perm 952-445-2840. Permit expired without required inspections. 4/9/2009 CE equirements should be directed to Mark Anderson, State Electrical Inspector, Fee Summary: ME - Permit Fee (Replacements) Surcharge -Fixed $50.00 0801.4088 $0.50 9001.2195 Total: $50.50 Contractor: Sedgwick Heating & Air 8910 Wentworth Ave S Minneapolis MN 55420 (952) 881-7739 - Applicant - Owner: Mary Ann Timm 1617 Clemson Dr B Eagan MN 55122 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Applicant/Permitee: Signature Issued By: Signature City of Eagan Eagan, PERMIT City of Eaan Permit Type: Building Permit Number: EA104523 Date Issued: 05/25/2012 Permit Category: ePermit Site Address: 1617 Clemson Dr B Lot: 2 Block: 02 Addition: The Trails Of Thomas Lake PID: 10-75865-02-020 Use: Description: Sub Type: e-Windows/Doors Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 - Applicant - Owner: Mary Ann Timm 1617 Clemson Dr B Eagan MN 55122 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature ..ITY OF EAGS$N 3830 Pilot Knob Road P.O. Box 21199 DATE: Eagan, MN 55121 zoning: No. of Units: 1 unit z 071 4ple' ---- - Owner: _--- Address: Site Addess: n _ Plumber: .r — -- Meter No.: Size: Reader No.: I agree to comply with the City of Eagan Ordinances. WATER SERVICE PERMIT 342`: PERMIT NO.: ?713 7 By it Connection Charge: Account Deposit: -- Permit Fee: Surcharge: Misc. Charges: --- Total: (g Date Paid: Insp.: Date of Insp.. CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road PERMIT NO.: P.O. Box 21199 Eagan, MN 55121 DATE: Zoning: No. of Units: Owner Address. Site Address. Plumber. I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: City of Eagan PERMIT City of Eaan Permit Type: Plumbing Permit Number: EA109373 Date Issued: 02/28/2013 Permit Category: ePermit Site Address: 1617 Clemson Dr B Lot: 2 Block: 02 Addition: The Trails Of Thomas Lake PID: 10-75865-02-020 Use: Description: Sub Type: Residential Work Type: Replace Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Kris Dien 3670 Dodd Rd Eagan, mn 55123 651-365-1340 Fee Summary: PL - Permit Fee (WS &/or WH) $55.00 Surcharge -Fixed $5.00 0801.4087 9001.2195 Total: $60.00 Contractor: Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 - Applicant - Owner: Mary Ann Timm 1617 Clemson Dr B Eagan MN 55122 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature City of Eapil 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: i4q LP Permit Fee: Date Received: CI IN S I Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION J q/a'// 3 site Address: /07 rn /'bilis 4/i0k 173 (q Lt *5r 9 6 l e unit #: Date: � � 3 � Resident/ Owner Name: TN/ L of- (/140M9 -i L,K, [-i. A / . Phone19 7f17 7Sj/ Address / City / Zip: r+174/ f Applicant is: Owner Contractor Type;ofWork Description of work: tit`/ goo( ` l'/CCC /iv 16 firCCS D t ..1 &Ivy i€ 4t 7 /4 I" Construction Cost:.(9-•-g..072---- .. ....___lilt-Famity- i#ding. (Yes fNo- ) i Contractor v : TLB �-' . -1 h o, t -,prie Company: Contact: q,39 urL_i�, l w1 Ci t N ntixa o Address: City: in(‘ 53a~2-7(17- 75 -/ State: Zip: • Phone:' B c. i 22: � R a�, NAT -2-3D.90 — 1 .LI -Liccnsc #:• — — Lead Certificate #: If the, project is exempt from lead certification, please explain why: (see Page 3 for additional information) ifrd /2 , -'t he,,,‘f� D,Frvpi-e) - Vi nay 1 c f%/t> In the' ast 12 months, _Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: 'G Vb .^�r'� �4 s �s '�s NOT Mans and supporting documents.ihat,you ubm( pare ci s[de,red foVbe p ,rbl c nnformat► n- Port ons of �r r..#r t+ -.L ---.,. . ®rrnation maybe clasifiedvas non•-�publ�c-[f you�pr tilde specific yeas' hs that�would pent, [ty the) . - ` coneludl That the ; arre tr cle, sea"rets:'a"" CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www. gooherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that "I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance', with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issua e. xi es low fie. x Applica s Printed Name Ap icant's Signature /L1 Page 1 of 3 City of Eagan PERMIT 41' City of Eaan Permit Type: Building Permit Number: EA148511 Date Issued: 04/03/2018 Permit Category: ePermit Site Address: 1617 Clemson Dr B Lot: 2 Block: 02 Addition: The Trails Of Thomas Lake PID: 10-75865-02-020 Use: Description: Sub Type: Fireplace Construction Type: Work Type: Gas Insert Description: Census Code: 434 - Residential Additions, Alterations Occupancy: Zoning: Square Feet: 0 Comments: Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary: Valuation: 3,000.00 BL - Base Fee $3K $88.50 Surcharge - Based on Valuation $3K $1.50 0801.4085 9001.2195 Total: $90.00 Contractor: Fireside Hearth & Home 2700 Fairview Ave N Roseville MN 55113 (651) 633-2561 - Applicant - Owner: Cheryl Pistulka 1617 Clemson Dr B Eagan MN 55122 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA156224 Date Issued:06/20/2019 Permit Category:ePermit Site Address: 1617 Clemson Dr B Lot:2 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-020 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Cheryl Pistulka 1617 Clemson Dr B Eagan MN 55122 (651) 238-8966 Gladstone's Window & Door Store 2475 Maplewood Drive Suite 110 Maplewood MN 55109-0000 (651) 774-8455 Applicant/Permitee: Signature Issued By: Signature